According to the site of recurrence/metastasis, gastric cancer recurrence/metastasis can be divided into the following categories: local recurrence in the surgical region (including recurrence in regional lymph nodes and residual stomach), peritoneal recurrence, hepatic metastasis, hematogenous metastasis in organs other than the liver, distant lymph node metastasis in non-surgical regions, and compound recurrent metastasis.
Symptoms will vary with different types of recurrence/metastasis. In general, gastric cancer recurrence presents with stomach pain that is not significantly related to eating, and some patients present with peptic ulcer-like pain (pain relieved after eating). Patients may also experience upper abdominal fullness, anorexia, abdominal pain, diarrhea, emaciation, anemia, edema, fever, etc. When the tumor invades the pylorus, it can also cause symptoms of pyloric obstruction such as nausea and vomiting.
After distant metastasis occurs, the metastatic sites such as liver, lung, brain, prostate, ovary, and bone marrow will show corresponding manifestations. In the case of gastric cancer, liver metastases and lung metastases are more common: in the case of liver metastases, pain in the liver area, edema, jaundice, patients can feel the enlarged liver, and may also show symptoms related to ascites (such as abdominal bulging, lower limb edema, etc.); in the case of lung metastases, symptoms such as cough, shortness of breath, sputum, hemoptysis, and chest pain are often present. (Wenbin Hou, Department of Gastrointestinal Oncology, The First Hospital of China Medical University, participated in the answer)